Hi there! It's been a while since you posted your question, but I hope you'll be coming back.

First off, I am not diabetic. However, I have been told by multiple foot & ankle specialists - DPMs and OSs - that I have Charcot-like processes going on in my right foot. The end result, whether one agrees with that statement or not, is that I have a foot that for all intense and purposes looks like and functions like a Charcot foot.

Secondly, yes, I have had some foot surgery. I've had two mid-foot fusions and more surgery is in my future. And yes, I wear an AFO brace.

Are there particular questions you'd like to ask?

__________________Best wishes to all, FleaFly

"The way I see it, if you want the rainbow, you gotta put up with the rain." ~ Dolly Parton

I have seen several high end orthopedic doctors and they state that my foot is not worth saving. They state that the Talus bone is completely gone! Their suggestion is a BTKA. Well, as long as I have feeling, blood flow, and can walk with it in a cam boot, no one is cutting it off! My Medicare is effective March 2014 so I will use that to reach out to doctors across the US.
I don't understand why they just can't do a Talus rebuild and fuse everything together. I'm thinking because I have no insurance or money, this is the reason why.

__________________
The anticipation of death is worse than death itself!

You said you can still walk around in a cam boot. That's great if it works for you. Why then have anything done? Is pain the issue? Ulcers? Increasing loss of function? Is the blood flow decreasing from what it was a year or two ago?

Having more opinions can't be a bad thing, but do you know why the surgeons you've seen say your foot is not worth saving? Diabetics, in particular, carry extra risks into fusion surgery, especially with the prevalence of neuropathy, circulatory and wound healing issues. Could it be that the OSs feel your risks are disproportionately high to undergo the talon surgery?

What are your expectations were you to have the surgery you propose? How active are you today and how active do you expect or want to be in the future?

I'm no authority on all of this, but I am very aware due to my own situation. For me, having already had fusion surgeries and having them fail, the paramount question is what are my expectations? What do I want my life to be like after the fusion or amputation surgery? With which procedure can I best accomplish this and maintain it for the rest of my life? That's my big question. Even without complications or failures, the trade-off is what condition I might be in with a fusion vs. with a BK prosthesis.

Fusion surgery, by definition, removes a certain amount of flexibility from the foot. That then opens you to potential problems with adjoining joints. Foot fusions require a long and difficult recovery and have a rate of failure that some might consider unacceptable depending on the circumstances. After an amputation, as I understand it, the amputee can be up and walking around on a temporary prosthesis in about two months, and often less, barring any complications, of course. With the fusion surgery, the patient would still be counting the weeks remaining before the cast might come off.

I am definitely not suggesting that you jump onto the amputation bandwagon. But, if you're thinking that the amputation surgery costs more to have done than the other foot surgery, I would venture to say that most likely the opposite is true. Amputations are generally faster surgeries compared to fusions, and if you add in other processes (bone grafts, tendon transfers, etc.) even more time would be spent on the fusion surgery. Time = money, so I think the amputation is probably the less expensive procedure to have done.

If you don't mind sharing your thoughts, I would very much like to know what you're thinking and why. Any insight into someone else's situation offers another bit of light into my own.

__________________Best wishes to all, FleaFly

"The way I see it, if you want the rainbow, you gotta put up with the rain." ~ Dolly Parton